Assistência à saúde mental nos serviços médicos de emergência: revisão integrativa / Asistencia a la salud mental en los servicios médicos de emergencia: revisión integrativa / Mental health care in emergency medical services: an integrative review

Objetivos: conhecer as características da assistência à saúde mental dispensada por profissionais de enfermagem nos serviços médicos de emergência. Método: revisão integrativa de literatura nas bases de dados Literatura Latino-Americano e do Caribe em Ciências da Saúde (LILACS), Publisher Medline (PUBMED), SciVerse Scopus (SCOPUS) e Cumulative Index to Nursing and Allied Health Literature (CINAHL), no período de março a junho de 2023, utilizando-se critérios de inclusão e exclusão previamente definidos. Resultados: obteve-se uma amostra final de 59 artigos os quais foram agrupados nas seguintes categorias temáticas: concepções em saúde mental, comunicação, intervenções, atendimento em rede, competência em cuidado em saúde mental e barreiras durante os atendimentos. Conclusão: o cuidado é feito de forma incipiente e permeado por elementos dificultadores. Os achados do presente estudo servem para rever e repensar práticas e políticas de cuidado em saúde mental e promover estratégias de aperfeiçoamento dos processos de trabalho.

Objetivos: conocer las características de la asistencia a la salud mental dispensada por profesionales de enfermería en los servicios médicos de emergencia. Método: revisión integrativa de literatura en las bases de datos Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Publisher Medline (PUBMED), SciVerse Scopus (SCOPUS) y Cumulative Index to Nursing and Allied Health Literature (CINAHL), en el período de marzo a junio de 2023, utilizando criterios de inclusión y exclusión previamente definidos. Resultados: se obtuvo una muestra final de 59 artículos los cuales fueron agrupados en las siguientes categorías temáticas: concepciones en salud mental, comunicación, intervenciones, atención en red, competencia en atención en salud mental y barreras durante los atendimientos. Conclusión: el cuidado es hecho de forma incipiente y permeado por elementos difíciles. Los hallazgos del presente estudio sirven para revisar y repensar prácticas y políticas de cuidado en salud mental y promover estrategias de perfeccionamiento de los procesos de trabajo.

Objective: to know the characteristics of mental health care provided by nursing professionals in emergency medical services. Method: integrative literature review in the databases Latin American and Caribbean Health Sciences Literature (LILACS), Publisher Medline (PUBMED), SciVerse Scopus (SCOPUS) and Cumulative Index to Nursing and Allied Health Literature (CINAHL), from March to June 2023, using previously defined inclusion and exclusion criteria. Results: the final sample included 59 articles, which were grouped into the following thematic categories: conceptions in mental health, communication, interventions, network care, competence in mental health care and barriers during care. Conclusion: care is done incipient and permeated by difficult elements. The findings of this study serve to review and rethink mental health care practices and policies and promote strategies for improving work processes.

Emergency department visits due to hand trauma and subsequent emergency hand surgery in three Finnish hospitals during the first and second waves of COVID-19 pandemic.

INTRODUCTIONS: The rate of acute hand trauma visits to emergency departments (ED) and surgeries decreased during the COVID-19 lockdown. Our aim was to analyze the influence of national lockdown during the first wave and the regional restrictions during the second wave on the rate of visits to the ED and urgent hand surgeries in Finland. METHODS: Material for this retrospective study was gathered from three Finnish hospitals All ED visits and urgent or emergency surgeries from January 2017 to December 2020 were included. Incidences per 100 000 persons with 95% confidence intervals (CI) were calculated and compared by incidence rate ratios (IRR). RESULTS: The incidence of hand injury was lower after the beginning of the lockdown in March 2020 (IRR 0.70 CI 0.63-0.78). After lockdown ended in May, the monthly incidences of ED visits returned to the reference level. During the lockdown, the incidence of fractures and dislocations was 42% lower in March (IRR 0.58 CI 0.50-0.68) and 33% lower in April 2020 (IRR 0.67 CI 0.57-0.80). The incidence of fracture repair surgeries was 43% lower in March 2020 (IRR 0.57 CI 0.35-0.93) and 41% lower in July 2020 (IRR 0.59 CI 0.36-0.98). Incidence of replantation was 49% higher in March 2020 (IRR 1.49 CI 0.53-4.20) and 200% higher in July 2020 (IRR 3.00 CI 0.68-13.2) but these increases had high uncertainty. CONCLUSIONS: The rate of ED visits due to hand injuries decreased while the rate of emergency hand operations remained unchanged during the national COVID-19 lockdown in spring. After the lockdown, the incidences returned to reference level and were unaffected by regional restrictions during the second wave of pandemic.

Confidence and knowledge in emergency management among medical students across Colombia: A role for the WHO basic emergency care course.

INTRODUCTION: Globally, medical students have demonstrated knowledge gaps in emergency care and acute stabilization. In Colombia, new graduates provide care for vulnerable populations. The World Health Organization (WHO) Basic Emergency Care (BEC) course trains frontline providers with limited resources in the management of acute illness and injury. While this course may serve medical students as adjunct to current curriculum, its utility in this learner group has not been investigated. This study performs a baseline assessment of knowledge and confidence in emergency management taught in the BEC amongst medical students in Colombia. METHODS: A validated, cross-sectional survey assessing knowledge and confidence of emergency care congruent with BEC content was electronically administered to graduating medical students across Colombia. Knowledge was evaluated via 15 multiple choice questions and confidence via 13 questions using 100 mm visual analog scales. Mean knowledge and confidence scores were compared across demographics, geography and prior training using Chi-Squared or one-way ANOVA analyses. RESULTS: Data were gathered from 468 graduating medical students at 36 institutions. The mean knowledge score was 59.9% ± 23% (95% CI 57.8-62.0%); the mean confidence score was 59.6 mm ±16.7 mm (95% CI 58.1-61.2). Increasing knowledge and confidence scores were associated with prior completion of emergency management training courses (p<0.0001). CONCLUSION: Knowledge and confidence levels of emergency care management for graduating medical students across Colombia demonstrated room for additional, specialized training. Higher scores were seen in groups that had completed emergency care courses. Implementation of the BEC as an adjunct to current curriculum may serve a valuable addition.

Hospital Presentations of Acute Diverticulitis During COVID-19 Pandemic may be More Likely to Require Surgery due to Increased Severity: A Single-Centre Experience.

BACKGROUND: The novel coronavirus disease 2019 (COVID-19) pandemic has resulted in fewer emergency presentations of many acute medical and surgical conditions. The purpose of this study was to assess the severity of disease at presentation and quantify the change in number of presentations during this period. METHODS: This retrospective study includes all patients diagnosed with acute diverticulitis on abdominopelvic computerised tomography (CT) between March 1, 2020 and June 30, 2020, compared to the same period in 2019. Follow up scans on the index admission were excluded. Hinchey grade was assessed for all CT scans. Inflammatory markers were analysed, along with outcome measures including length of stay and mortality. RESULTS: Acute diverticulitis was diagnosed in 52 CT scans in the acute pandemic period - a decrease of 51.4%. Average age at presentation was unchanged (63.3 ± 14.3 vs. 62.8 ± 13.8, P = .848). The number of Hinchey II, III and IV presentations were significantly higher in the acute pandemic period (28.8% vs. 11.2%, P = .005) and significantly more emergency operations were carried out (7.69% vs. .93%, P = .04). Mortality was not significantly increased, nor were serum levels of C-reactive protein, white cell count and lactate. DISCUSSION: During the COVID-19 pandemic, fewer patients presented and were diagnosed with acute diverticulitis. A significantly greater proportion presented at a more advanced stage and required emergency surgery, suggesting late presentation. Our findings support the need for maintaining acute surgical services and the provision of early radiological and surgical input in patients presenting with signs and symptoms of acute diverticulitis in future pandemics.

Emergency Medical Services and Syndromic Surveillance: A Comparison With Traditional Surveillance and Effects on Timeliness.

OBJECTIVE: Traditional public health surveillance of nonfatal opioid overdose relies on emergency department (ED) billing data, which can be delayed substantially. We compared the timeliness of 2 new data sources for rapid drug overdose surveillance-emergency medical services (EMS) and syndromic surveillance-with ED billing data. METHODS: We used data on nonfatal opioid overdoses in Kentucky captured in EMS, syndromic surveillance, and ED billing systems during 2018-2019. We evaluated the time-series relationships between EMS and ED billing data and syndromic surveillance and ED billing data by calculating cross-correlation functions, controlling for influences of autocorrelations. A case example demonstrates the usefulness of EMS and syndromic surveillance data to monitor rapid changes in opioid overdose encounters in Kentucky during the COVID-19 epidemic. RESULTS: EMS and syndromic surveillance data showed moderate-to-strong correlation with ED billing data on a lag of 0 (r = 0.694; 95% CI, 0.579-0.782; t = 9.73; df = 101; P < .001; and r = 0.656; 95% CI, 0.530-0.754; t = 8.73; df = 101; P < .001; respectively) at the week-aggregated level. After the COVID-19 emergency declaration, EMS and syndromic surveillance time series had steep increases in April and May 2020, followed by declines from June through September 2020. The ED billing data were available for analysis 3 months after the end of a calendar quarter but closely followed the trends identified by the EMS and syndromic surveillance data. CONCLUSION: Data from EMS and syndromic surveillance systems can be reliably used to monitor nonfatal opioid overdose trends in Kentucky in near-real time to inform timely public health response.

Causes of early postpartum complications that result in visits to the emergency department.

OBJECTIVE: This study aimed to review the reasons why postpartum women present to the emergency department (ED) over a short term (≤10 days post-delivery) and to identify the risk factors associated with early visits to the ED. METHODS: This retrospective chart review included all women who delivered at a regional health system (William Osler Health System, WOHS) in 2018 and presented to the WOHS ED within 10 days after delivery. Baseline descriptive statistics were used to examine the patient demographics and identify the timing of the postpartum visit. Univariate tests were used to identify significant predictors for admission. A multivariate model was developed based on backward selection from these significant factors to identify admission predictors. RESULTS: There were 381 visits identified, and the average age of the patients was 31.22 years (SD: 4.83), with median gravidity of 2 (IQR: 1-3). Most patients delivered via spontaneous vaginal delivery (53.0%). The median time of presentation to the ED was 5.0 days, with the following most common reasons: abdominal pain (21.5%), wound-related issues (12.6%), and urinary issues (9.7%). Delivery during the weekend (OR 1.91, 95% CI 1.00-3.65, P = 0.05) was predictive of admission while Group B Streptococcus positive patients were less likely to be admitted (OR 0.22, CI 0.05-0.97, P<0.05). CONCLUSIONS: This was the first study in a busy community setting that examined ED visits over a short postpartum period. Patient education on pain management and wound care can reduce the rate of early postpartum ED visits.

Framework for creating an incident command center during crises.

The Hospital Incident Command System (HICS) is an incident management system specific to hospitals based on the principles of Incident Command System (ICS), and it includes prevention, protection, mitigation, response, and recovery. It plays a crucial role in effective and timely response during the periods of disasters, mass casualties, and public health emergencies. In recent times, hospitals have used a customized HICS structure to coordinate effective responses to public health problems such as the Ebola outbreak in the US and SARS epidemic in Taiwan. The current COVID-19 pandemic has placed unprecedented challenges on the healthcare system, necessitating the creation of HICS that can help in the proper allocation of resources and ineffective utilization of healthcare personnel. The key elements in managing a response to this pandemic include screening and early diagnosis, quarantining affected individuals, monitoring disease progression, delivering appropriate treatment, and ensuring an adequate supply of personal protective equipment (PPE) to healthcare staff.

Pediatric hospital care organization: Cross-sectional enquiry in four regions in France.

OBJECTIVE: The aim of this study was to characterize conventional pediatric care capacities in French public hospitals and identify the main difficulties in guiding upcoming health policies. The secondary objective was to assess the quality of care by the implementation of the European Charter of the Rights of Children in Hospital. METHOD: Multicenter cross-sectional study using a questionnaire survey sent by e-mail to the heads of conventional pediatric departments in four French regions identified on the French Hospital Federation's website. The survey was conducted between 25 September and 25 October 2018. RESULTS: Fifty-six of 113 heads of departments participated in the survey. The mean annual number of admissions per unit in 2017 was 2066 (SD, 1433), with a median length of stay of 2.7 days (range, 1-10). Children were admitted up to age 18 years in 76% of the departments, and 83% of the departments had an individualized pediatric emergency department. The nurse care load was very high, specifically during the night shift (9.5 patients/nurse). Inpatient education and academic teaching were unavailable in 38% of the departments. Overall, 89% of department heads declared knowing the European Charter of the Rights of Children in Hospital, and a copy of it was posted in all units in 57% (95% confidence interval, 44-70) of the services/departments. At all times and in all departments, parents were allowed to be with their children, and for 34% (95% CI, 21-47) of the departments, an accommodation for parents was available close to the hospital. CONCLUSION: Public hospital pediatric departments lack sufficient medical and nonmedical caregivers. Department heads were well aware of the European Charter, and it was well disseminated but should be updated to address today's challenges in pediatrics. An area of improvement would be to include parents in their child's care more effectively.

Impact of the SARS-COV-2 Pandemic on the Endovascular Treatment of Acute Stroke - an Italian Single-Center Experience.

OBJECTIVES: The SARS-CoV-2 pandemic greatly influenced the overall quality of healthcare. The purpose of this study was to compare the time variables for acute stroke treatment and evaluate differences in the pre-hospital and in-hospital care before and during the SARS-CoV-2 pandemic, as well as between the first and second waves. MATERIALS AND METHODS: Observational and retrospective study from an Italian hospital, including patients who underwent thrombectomy between January 1st 2019 and December 31st 2020. RESULTS: Out of a total of 594 patients, 301 were treated in 2019 and 293 in 2020. The majority observed in 2019 came from spoke centers (67,1%), while in 2020 more than half (52%, p < 0.01) were evaluated at the hospital's emergency room directly (ER-NCGH). When compared to 2019, time metrics were globally increased in 2020, particularly in the ER-NCGH groups during the period of the first wave (N = 24 and N = 56, respectively): "Onset-to-door":50,5 vs 88,5, p < 0,01; "Arrival in Neuroradiology - groin":13 vs 25, p < 0,01; "Door-to-groin":118 vs 143,5, p = 0,02; "Onset-to-groin":180 vs 244,5, p < 0,01; "Groin-to-recanalization": 41 vs 49,5, p = 0,03. When comparing ER-NCGH groups between the first (N = 56) and second (N = 49) waves, there was an overall improvement in times, namely in the "Door-to-CT" (47,5 vs 37, p < 0,01), "Arrival in Neuroradiology - groin" (25 vs 20, p = 0,03) and "Onset-to-groin" (244,5 vs 227,5, p = 0,02). CONCLUSIONS: During the SARS-CoV-2 pandemic, treatment for stroke patients was delayed, particularly during the first wave. Reallocation of resources and the shutting down of spoke centers may have played a determinant role.

The Emergency Medicine Physician Workforce: Projections for 2030.

STUDY OBJECTIVE: The goals of this study were to determine the current and projected supply in 2030 of contributors to emergency care, including emergency residency-trained and board-certified physicians, other physicians, nurse practitioners, and physician assistants. In addition, this study was designed to determine the current and projected demand for residency-trained, board-certified emergency physicians. METHODS: To forecast future workforce supply and demand, sources of existing data were used, assumptions based on past and potential future trends were determined, and a sensitivity analysis was conducted to determine how the final forecast would be subject to variance in the baseline inputs and assumptions. Methods included: (1) estimates of the baseline workforce supply of physicians, nurse practitioners, and physician assistants; (2) estimates of future changes in the raw numbers of persons entering and leaving that workforce; (3) estimates of the productivity of the workforce; and (4) estimates of the demand for emergency care services. The methodology assumes supply equals demand in the base year and estimates the change between the base year and 2030; it then compares supply and demand in 2030 under different scenarios. RESULTS: The task force consensus was that the most likely future scenario is described by: 2% annual graduate medical education growth, 3% annual emergency physician attrition, 20% encounters seen by a nurse practitioner or physician assistant, and 11% increase in emergency department visits relative to 2018. This scenario would result in a surplus of 7,845 emergency physicians in 2030. CONCLUSION: The specialty of emergency medicine is facing the likely oversupply of emergency physicians in 2030. The factors leading to this include the increasing supply of and changing demand for emergency physicians. An organized, collective approach to a balanced workforce by the specialty of emergency medicine is imperative.

Changes in presentation, presenting severity and disposition among patients accessing emergency services during the first months of the COVID-19 pandemic in Calgary, Alberta: a descriptive study.

BACKGROUND: The COVID-19 pandemic has resulted in unique pressures on the emergency services system. This study describes changes in the presentation, presenting severity and disposition of patients accessing emergency services in Calgary, Alberta, during the first wave of the pandemic. METHODS: In this descriptive study, we constructed a population cohort of all patients who accessed emergency services by calling emergency medical services (EMS) (ambulance service that provides prehospital treatment and transport to medical facilities) or presenting directly to an emergency department (4 adult and 1 pediatric) or 2 urgent care centres in Calgary during the exposure period (December 2019 to June 2020) compared to 2 historical control periods (December to June, 2017-2018 and 2018-2019) combined. Outcomes included frequency of presentation, system flow indicators, patient severity, disposition and mortality. We used a locally estimated scatterplot smoothing function to visualize trends. We described differences at the maximum and minimum point of the exposure period compared to the control period. RESULTS: A total of 1 127 014 patient encounters were included. Compared to the control period, there was a 61% increase in the number of patients accessing EMS and a 35% decrease in the number of those presenting to an adult emergency department or urgent care centre in the COVID-19 period. The proportion of EMS calls for the highest-priority patients remained stable, whereas the proportion of patients presenting to an emergency department or urgent care centre with the highest-priority triage classification increased transiently by 0.9 percentage points (increase of 89%). A smaller proportion of patients were transported by EMS (decrease of 21%), and a greater proportion of emergency department patients were admitted to hospital (increase of 25%). After the first case was reported, the mortality rate among EMS patients increased by 265% (3.4 v. 12.4 per 1000 patient encounters). INTERPRETATION: The first wave of the COVID-19 pandemic was associated with substantial changes in the frequency and disposition of patients accessing emergency services. Further research examining the mechanism of these observations is important for mitigating the impact of future pandemics.

A Decade of Terrorism in the United States and the Emergence of Counter-Terrorism Medicine.

BACKGROUND: The United States (US) is ranked 22nd on the Global Terrorism Index (2019), a scoring system of terrorist activities. While the global number of deaths from terrorism over the past five years is down, the number of countries affected by terrorism is growing and the health care repercussions remain significant. Counter-Terrorism Medicine (CTM) is rapidly emerging as a necessary sub-specialty, and this study aims to provide the epidemiological context over the past decade supporting this need by detailing the unique injury types responders are likely to encounter and setting the stage for the development of training programs utilizing these data. METHODS: The Global Terrorism Database (GTD) was searched for all attacks in the US from 2008-2018. Attacks met inclusion criteria if they fulfilled the three terrorism-related criteria as set by the GTD. Ambiguous events were excluded when there was uncertainty as to whether the incident met all of the criteria for inclusion in the GTD. The grey literature was reviewed, and each event was cross-matched with reputable international and national newspaper sources online to confirm or add details regarding weapon type used and, whenever available, details of victim and perpetrator fatalities and injuries. RESULTS: In total, 304 events were recorded during the period of study. Of the 304 events, 117 (38.5%) used incendiary-only weapons, 80 (26.3%) used firearms as their sole weapon, 55 (18.1%) used explosives, bombs, or dynamite (E/B/D), 23 (7.6%) were melee-only, six (2.0%) used vehicles-only, four (1.3%) were chemicals-only, two (0.7%) used sabotage equipment, two (0.7%) were listed as "others," and one (0.3%) used biological weapon. There was no recorded nuclear or radiological weapon use. In addition, 14 (4.6%) events used a mix of weapons. CONCLUSIONS: In the decade from 2008 through 2018, terrorist attacks on US soil used weapons with well-understood injury-causing modalities. A total of 217 fatal injuries (FI) and 660 non-fatal injuries (NFI) were sustained as a result of these events during that period.Incendiary weapons were the most commonly chosen methodology, followed by firearms and E/B/D attacks. Firearm events contributed to a disproportionality high fatality count while E/B/D events contributed to a disproportionally high NFI count.

Case-control study of patient characteristics, knowledge of the COVID-19 disease, risk behaviour and mental state in patients visiting an emergency room with COVID-19 symptoms in the Netherlands.

BACKGROUND: Coronavirus disease 2019 is a serious respiratory virus pandemic. Patient characteristics, knowledge of the COVID-19 disease, risk behaviour and mental state will differ between individuals. The primary aim of this study was to investigate these variables in patients visiting an emergency department in the Netherlands during the COVID-19 pandemic and to compare the "COVID-19 suspected" (positive and negative tested group) with the "COVID-19 not suspected" (control group) and to compare in the "COVID-19 suspected" group, the positive and negative tested patients. METHODS: Consecutive adult patients, visiting the emergency room at the Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands, were asked to fill out questionnaires on the abovementioned items on an iPad. The patients were either "COVID-19 suspected" (positive and negative tested group) or "COVID-19 not suspected" (control group). RESULTS: This study included a total of 159 patients, 33 (21%) tested positive, 85 (53%) negative and 41 (26%) were COVID-19 not suspected (control group). All patients in this study were generally aware of transmission risks and virulence and adhered to the non-pharmaceutical interventions. Working as a health care professional was correlated to a higher risk of SARS-Cov-2 infection (p- value 0.04). COVID-19 suspected patients had a significantly higher level of anxiety compared to COVID-19 not suspected patients (p-value < 0.001). The higher the anxiety, the more seriously hygiene measures were followed. The anxiety scores of the patients with (pulmonary) comorbidities were significantly higher than without comorbidities. CONCLUSION: This is one of the first (large) study that investigates and compares patient characteristics, knowledge, behaviour, illness perception, and mental state with respect to COVID-19 of patients visiting the emergency room, subdivided as being suspected of having COVID-19 (positive or negative tested) and a control group not suspected of having COVID-19. All patients in this study were generally aware of transmission risks and virulence and adhered to the non-pharmaceutical interventions. COVID-19 suspected patients and patients with (pulmonary) comorbidities were significantly more anxious. However, there is no mass hysteria regarding COVID-19. The higher the degree of fear, the more carefully hygiene measures were observed. Knowledge about the coping of the population during the COVID-19 pandemic is very important, certainly also in the perspective of a possible second outbreak of COVID-19.

Actividad y asistencia a la parada cardiorrespiratoria en un servicio extrahospitalario de emergencias durante la pandemia COVID-19 / Caseload and cardiopulmonary arrest management by an out-of-hospital emergency service during the COVID-19 pandemic

Objetivos. Conocer las consecuencias de la pandemia COVID-19 en la atención a la parada cardiorrespiratoria (PCR) extrahospitalaria con relación al inicio de las maniobras de resucitación cardiopulmonar (RCP) y su supervivencia. Valorar el impacto de la pandemia por COVID-19 en la actividad asistencial de un servicio de urgencias y emergencias extrahospitalarias en comparación con otros periodos sin enfermedad.Método. Estudio observacional prospectivo, basado en un registro continuo de PCR extrahospitalaria del SUMMA 112 de Madrid, durante el periodo del 1 de marzo al 30 de abril del 2020. Las variables se recogieron siguiendo las recomendaciones Utstein. Se utilizó el periodo de marzo-abril 2019 como control de comparación directa con el periodo de estudio y los periodos de enero-febrero de 2019 y de 2020 para conocer la variabilidad entre dichos años.Resultados. De las 313 PCR atendidas en marzo-abril de 2020, en 146 casos se realizó RCP avanzada. De los 87 pacientes catalogados COVID positivo, llegaron vivos al hospital 33. No se aplicaron maniobras de RCP avanzada en 167 ocasiones, identificando como causa más frecuente el tiempo de colapso excesivo. El 92,7% de las PCR sucedieron en domicilio. Comparado con otros periodos, hubo más llamadas al centro coordinador de urgencias en marzo-abril de 2020, si bien la movilización de recursos fue similar.Conclusiones. Durante la pandemia de COVID-19 hubo más mortalidad en la PCR extrahospitalaria, aumentando el porcentaje de PCR sin RCP avanzada, destacando como principal causa el tiempo de colapso excesivo. Sin embargo, aunque se incrementó significativamente la demanda telefónica, este servicio de emergencias extrahospitalarias no tuvo aumento en la movilización de los recursos móviles asistenciales. (AU)

Objective. To describe the effect of the coronavirus disease 2019 (COVID-19) pandemic on the initiation of cardiopulmonary resuscitation (CPR) in patients with out-of-hospital cardiopulmonary arrest. To compare the cardiopulmonary arrest caseload during the pandemic to the caseloads in other periods.Methods. Observational, prospective study based on the registry of out-of-hospital cardiopulmonary arrest emergencies the SUMMA112 ambulance service responded to between March 1 and April 30, 2020, in the Spanish autonomous community of Madrid. The registry is a Utstein-style database. The period of March–April 2019 was the control period for direct comparison with the 2020 study period and with the January–February periods of 2019 and 2020.Results. The responders undertook advanced CPR in 146 of the 313 cardiopulmonary arrest cases registered during March-April, 2020. Of the 87 patients with COVID-19–positive tests, 33 reached the hospital alive. Advanced CPR was not applied in 167 cases; the most frequent reason was prolonged circulatory collapse. Most cases (92.7%) occurred in the home. The emergency dispatchers received more calls in March and April of 2020, but they sent out a similar number of ambulances.Conclusions. Mortality was higher in cases of cardiopulmonary arrest during the COVID-19 pandemic. The percentage of cases with no application of advanced CPR rose; the main reason was the amount of time between collapse and first response. Even though the number of emergency calls increased significantly, the SUMMA112 service did not dispatch more ambulances. (AU)